MATERNAL COMPLICATIONS

Question 1

• Absolute or relative lack of insulin leading to a spectrum of disorders involving carbohydrate, lipid & protein metabolism
• Associated with fetal anatomic anomalies
o Type I- insulin dependant (juvenile onset)
o Type II- non insulin dependant (adult onset usually needs insulin)

Answer 1

DIABETES MELLITUS

Question 2

• Hormonal and metabolic changes only associated w/ pregnancy result in glucose intolerance of pregnancy
• Occurs in 3rd trimester & assoc. w/ macrosomia (>90th percentile)

Answer 2

GESTATIONAL DIABETTES

Question 3

• POLY, preeclampsia, renal disfunction

* Hypoglycemia, peripheral vascular disease, infection & post partum hemorrhage

Answer 3

MATERNAL COMPLICATIONS OF MATERNAL DIABETEST

Question 4

• Neural tube defects, cardiac/ renal anomalies
• Clubfoot, SUA, polydactyly, GI/skeletal anomalies
• Impact on birth weight; IUGR vs. macrosomia
• Thick & mature placenta; OLI/POLY

Answer 4

FETAL COMPLICATIONS OF MATERNAL DIABETES

Question 5

• Maternal & fetal complications result from high BP
• 2 classification:
o Essential hypertension- exists prior to pregnancy
o P I H D- Pregnancy Induced Hypertensive Disorder
▪ Systolic > 140 mm Hg
▪ Diastolic > 90 mm Hg

Answer 5

HYPERTENSIVE DISORDERS

Question 6

• Proteinuria & neurological symptoms
• M/C occurs in primigravidas & multiple gestations
• 2 Classifications:
o Preeclampsia- HTN, edema, proteinuria
o Eclampsia – all of the above + coma & seizures
• S/S: HTN, ankle swelling, sudden & excessive weight gain, headaches, vomiting
• SONO: IUGR, oligo, ↓ placenta volume, ↑ placenta age, fetal demise

Answer 6

TOXEMIA

Question 7

• Severe, systemic maternal infection can cause spontaneous abortion, fetal demise or premature labor
• Chronic infections can cause IUGR or fetal abnormalities
• M/C utero infection are TORCH
o Toxoplasmosis- caused y protozoan ( T. gondii) found in cat feces & raw meat
▪ Causes CNS calcifications
o Other- eg. Syphilis
o Rubella- A.K.A German measles (most dangerous in 1st 5 weeks)
▪ Causes deafness, cataracts, congenital heart disease & retardation
o Cytomegalovirus- M/C infection causing embryonic demise
o Herpes- viral infection can be transmitted to fetus during delivery:
C-section usually performed

Answer 7

MATERNAL INFECTIONS

Question 8

• Painless premature dilation of the cervix
• Causes: habitual abortion & surgical repair of cx tears
o Surgical repairs up to 20 wks; “ Mc Donald” or “Shirodkar”
• Cervical < 3 cm before 34 weeks
• Cervical dilatation with a width >2 cm in 2nd trimester- MOST RELIABLE

Answer 8

INCOMPTENET CERIX

Question 9

• Onset of labor before 37 weeks

* Etiology: UT surgery or anomalies, stress, smoking, mult gestation

Answer 9

PRETERM LABOR

Question 10

• Spontaneous rupture of membranes prior to onset labor

* SONO: Oligo

Answer 10

PROM

Question 11

can ↑ in size & cause pain due to hemorrhage or torsion

Answer 11

• Leiomyomas/ fibroids

Question 12

if large enough may cause dystosia

1. corpus luteum cysts- produce progesterone & usually regress by 14th week, if persists can cause torsion
2. theca lutein- occur with trophoblastic disease & are usually bilateral, large & multi-septated

Answer 12

OVARIAN CYST